Ergometrine (other names include ergonovine and d-lysergic acid beta-propanolamide), is an ergoline (and lysergamide) derivative, and one of the primary ergot and morning glory alkaloids . It is chemically similar to LSD, ergine, and lysergic acid.

Pharmacokinetics

Ergometrine causes contraction of the uterine muscle. At low doses, there is an increase in frequency and amplitude of contractions while at higher doses, the basal tone of the uterus is increased. Ergometrine also causes vasoconstriction of peripheral and cerebral vessels.

Halothane causes relaxation of uterine muscle and may interfere with ergometrine action. Enhanced uterotonic effect with prostaglandins and oxytocin. Concurrent admin with CYP3A4 inhibitors may lead to vasospasm, cerebral ischaemia and/or ischaemia of extremities.Potentially Fatal: Enhanced vasoconstrictive effects with sympathomimetics and other vasoconstrictors

IntravenousExcessive uterine bleedingAdult: 200 mcg via IV inj over at least 1 minute. May follow with oral doses of 200-400 mcg 2-4 times daily until the danger of atony or haemorrhage has passed (usually 48 hours).

IntramuscularActive management of the 3rd stage of labourAdult: 500 mcg given with 5 units of oxytocin after delivery of the anterior shoulder of the infant or immediately after delivery.

IntramuscularTreatment and prevention of postpartum haemorrhageAdult: 200 mcg, may repeat in severe bleeding every 2-4 hours as needed.

List of Contraindications

Ergometrine and Pregnancy

Contraindicated in pregnancy.

Category X: Studies in animals or human beings have demonstrated foetal abnormalities or there is evidence of foetal risk based on human experience or both, and the risk of the use of the drug in pregnant women clearly outweighs any possible benefit. The drug is contraindicated in women who are or may become pregnant.